Objective: To mitigate transmission of SARS-CoV-2 infection and decrease exposure to the hospital setting, Mount Sinai Hospital implemented new protocols, including early postpartum discharge. Early discharge would allow for more single-bedded rooms, limiting exposure to other patients and their support persons. During the pandemic, patients were discharged to home on postpartum days one or two after vaginal or cesarean delivery, respectively, instead of day two or three, unless longer hospitalization was needed for medical indications. We aim to determine if the readmission rate was increased in the setting of earlier discharge during the COVID-19 pandemic.
Study Design: Historical cohort study comparing the readmission rate in SARS-CoV-2 negative women who presented to Mount Sinai Hospital for delivery admission from March-May 2019 versus March-May 2020. The primary outcome was readmission rate within six weeks of discharge day. Maternal and neonatal characteristics and outcomes were compared between groups using T-tests or Wilcoxon-Rank Sum tests for continuous measures and Chi-square or Fisher’s exact tests for categorical measures, as appropriate. Primary and secondary outcomes were assessed using linear and logistic univariable and multivariable regression.
Results: Patients in the 2020 cohort (n=1,078) were significantly less likely to have public/state insurance (p=0.02), more likely to have pre-gestational diabetes (p=0.02), gestational diabetes (p=0.04), gestational hypertension (p<0.01) and an operative vaginal or cesarean delivery (vs. spontaneous vaginal delivery, p=0.01) compared to 2019 cohort patients (n=1,910). Patients in the 2020 cohort were significantly more likely to have an earlier postpartum day of discharge and a shorter median length of stay compared to 2019 cohort patients (both p<0.01). Despite differences in length of stay, the rate of readmission was similar between the two groups (p=0.45).
Conclusion: During the COVID-19 pandemic, there was no difference in readmission rate despite shorter hospital stays.
The real-world Kyleena Satisfaction Study (KYSS) confirmed clinical findings that the levonorgestrel-releasing intrauterine system (LNG-IUS) 12 (Kyleena) is associated with high satisfaction and continuation rates. We report results from North American KYSS participants.
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